Estudo randomizado comparando drenagem versus não drenagem após linfadenectomia axilar por câncer de mama
| Autor: | Ribeiro, Luiz Fernando Jubé |
|---|---|
| Jazyk: | portugalština |
| Rok vydání: | 2010 |
| Předmět: | |
| Zdroj: | Repositório Institucional da UnBUniversidade de BrasíliaUNB. |
| Druh dokumentu: | Doctoral Thesis |
| Popis: | Tese (doutorado)—Universidade de Brasília, Convênio Rede Centro - Oeste (UnB, UFG, UFMS), 2010. Submitted by Albânia Cézar de Melo (albania@bce.unb.br) on 2011-06-07T15:57:20Z No. of bitstreams: 1 2010_LuizFernandoJubeRibeiro.pdf: 1212987 bytes, checksum: b7a758acf5d2007ef8f76223130c3656 (MD5) Approved for entry into archive by Patrícia Nunes da Silva(patricia@bce.unb.br) on 2011-06-09T18:53:56Z (GMT) No. of bitstreams: 1 2010_LuizFernandoJubeRibeiro.pdf: 1212987 bytes, checksum: b7a758acf5d2007ef8f76223130c3656 (MD5) Made available in DSpace on 2011-06-09T18:53:56Z (GMT). No. of bitstreams: 1 2010_LuizFernandoJubeRibeiro.pdf: 1212987 bytes, checksum: b7a758acf5d2007ef8f76223130c3656 (MD5) Introdução: A drenagem após linfadenectomia axilar reduz o número de punções evacuadoras para o seroma; não obstante, gera desconforto e ansiedade para a paciente. Objetivo: Avaliar a possibilidade de não se drenar a axila após linfadenectomia axilar em pacientes com câncer de mama. Métodos: Estudo randomizado incluindo 240 pacientes, portadoras de câncer de mama, submetidas à linfadenectomia axilar, alocadas em dois grupos: drenagem e não drenagem do leito operatório, como parte do tratamento de conservação mamária. Resultados: As características demográficas das pacientes foram semelhantes em ambos os grupos. Quanto às complicações, houve dois casos (2,4%) de deiscência no grupo com dreno, enquanto no grupo sem dreno, foram 13 (13,5%) casos (p=0,007, OR=3,70, IC95%= 1,31 – 13,59). As taxas de infecção, necrose e hematoma foram semelhantes entre os dois grupos. A mediana de volume aspirado foi de 0,00ml (0,00 – 270,00) no grupo drenado e de 522,50ml (130,00 – 1148,75) (p Introduction: Drainage following axillary lymphadenectomy reduces the number of evacuating punctures for seroma. Nonetheless, it causes discomfort and anxiety for patients. Objective: To evaluate the possibility of not draining the axilla following axillary lymphadenectomy for breast cancer patients. Methods: This randomized study included 240 breast cancer patients who underwent axillary lymphadenectomy as part of the breast conservation treatment. They were divided between two groups: with or without drainage of the operative bed. Results: The patients’ demographic characteristics were similar in the two groups. Regarding complications, there were two cases (2.4%) of dehiscence in the group with drainage, while there were 13 cases (13.5%) in the group without drainage (p = 0.007, OR = 3.70, 95% CI = 1.31 – 13.59). The infection, necrosis and hematoma rates were similar between the two groups. The median aspirated volume was 0.00 ml (0.00 – 270.00) in the drained group and 522.50 ml (130.00 – 1148.75) (p < 0.001) in the group without drainage. The median number of aspirations performed as part of the breast conservation treatment was 0.5 (0.0 – 4.0) and 5.0 (3.0 – 7.0), for the groups with and without drainage, respectively (p < 0.001). The volume of serous fluid was similar in the two groups. Conclusion: It is feasible to perform lymphadenectomy without axillary drainage, since the safety rate (total number of patients without complications) was similar in the two groups studied; however a greater numbers of evacuating punctures and occurrences of dehiscence of the operative wound might be expected. |
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